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has a 360-degree probe that is inserted into the vaginal canal directing and concentrating the laser all around the canal to manage these concerns. The fractional CO2 laser directly remodels the vaginal mucosa via new collagen formation and elastic fibers on the skin.4 I used the Venus CO2 laser, which is what the protocol, the Venus-VT, is based on, however there are others available that may be considered for this treatment. One study has suggested that fractional C02 lasers can improve the vaginal canal tightness beyond the introitus without causing damage to the surrounding tissue.3 The protocol also includes treating the labia minora and majora as a non-surgical labiaplasty.

Case Study: Treating Vaginal Laxity and Sexual Dysfunction Dr Natasha Ranga details how she successfully managed a patient’s intimate vulvovaginal concerns with CO2 fractional laser Globally, approximately 15% of the pre-menopausal population have vulvovaginal concerns,1 however the true figure may be underestimated as it is often being perceived as an embarrassing problem, so many patients may not seek help or treatment. Myself and Dr Jorge Zafra, who assisted me with this article, have personally noted an increase in popularity for vaginal treatments, however there is no one clear definition on what the procedure involves or its intended benefits.2 Managing concerns The concerns that many patients present with include vaginal laxity, dryness, urinary stress incontinence, sexual discomfort, dyspareunia and psychosexual problems.2 Vaginal rejuvenation addresses all of the above concerns, and refers to restoring a woman’s intimate health to a pre-menopausal state and a prepartum restoration. Sexuality plays an important part in a woman’s health, quality of life and general wellbeing. In my experience in general practice, these vaginal concerns are difficult to treat, and often women just put up with the concerns. Many women who have given birth vaginally, experience stretching of their vaginal tissue, while many post-menopausal women have vaginal atrophy changes. Both of these types of patients may have longterm physical and psychological consequences including loss of sensation, stress incontinence, vaginal laxity, and pain including dyspareunia or general intimate discomfort at anytime. Vaginal rejuvenation is the treatment of these concerns and lasers are at the forefront in the management.3 We have developed a protocol with a fractional CO2 laser that

Case study introduction In July 2016, 34-year-old Caucasian Patient A was treated for vaginal laxity and dryness. She had given birth to two children, the most recent being four years prior. In her consultation she said that she had had no previous non-surgical vaginal rejuvenation treatments. She also had no past medical history that would be significant to this procedure such as recent surgical labiaplasty, which is a clear contraindication. It should be noted that she had a Mirena coil in situ, previous surgical labiaplasty more than 10 years ago, no known drug allergies, no sexual health history, and cervical smears up to date with no abnormalities.

Treatment protocol: Cleanse the area with a mild antiseptic and allow to dry, so no residue is left to interfere with the fractional CO2 laser. • Fully insert the 360-degree laser head/vaginal probe and slowly withdraw it at 0.5cm intervals after each laser blast is delivered. Do not use any lubrication as this interferes with the laser treatment. • The laser is set to deliver the energy equally at 360 degrees in the vaginal canal; point energy is set to 19.0mj, power 19w and the duration 1.0ms. • There can be up to three passes of the laser treatment.

Sexuality plays an important part in a woman’s health, quality of life and general wellbeing

Reproduced from Aesthetics | Volume 4/Issue 2 - January 2017

Profile for Aesthetics Journal

Aesthetics January 2017  

Volume 4 / Issue 2 CONTOURING

Aesthetics January 2017  

Volume 4 / Issue 2 CONTOURING